Summary
Highlights
The host, Bailey Sarian, introduces the topic of lobotomy, recalling a high school science teacher who proudly displayed a 'lobotomy skull.' She explains her fascination with the subject, sparked during quarantine, revealing her initial misspellings and the rabbit hole of research it led her down. A lobotomy is defined as a surgery where portions of the brain are cut, leading to a loss of hopes, dreams, and feelings. The procedure, originating in the 1900s, was primarily intended to treat schizophrenia and make 'undesirables more agreeable.' Mental health was stigmatized, leading doctors to propose cutting parts of the brain that made people 'feel things,' essentially turning them into 'shells of a person.' The procedure often resulted in patients becoming 'zombies' or worsening their conditions, leading to permanent institutionalization. Lobotomies were rarely scientifically endorsed and were often performed without consent, targeting primarily women and individuals diagnosed with a broad range of 'schizophrenic' conditions like anxiety, depression, insomnia, and even homosexual tendencies.
A prime example of the horrific use of lobotomies is the story of Rosemary Kennedy, sister to JFK. Rosemary was a rebellious and unpredictable young woman, who enjoyed partying and was a source of embarrassment for her image-conscious family. Concerned about their reputation, her parents sought a treatment to 'fix' her. Her father learned about the new lobotomy surgery, believing it could eliminate Rosemary's mood swings and suppress her 'urges,' making her 'more agreeable.' In November 1941, he scheduled her for a lobotomy. The surgery involved drilling holes above each temple and inserting a butter knife-like instrument to cut nerve fibers in her brain. Doctors evaluated her responses, stopping when her words became jumbled. While the procedure made her calmer and less disagreeable, it reduced her mental capacity to that of a two-year-old. She lost the ability to walk, babbled, became incontinent, and was completely dependent on others. Her family, embarrassed by her normal self, then permanently hid her away. Her case highlights how the failures of lobotomies were often concealed, while supposed successes were publicized.
The search for mental health treatments has a long history, with a constant curiosity about the brain. In the 1930s, overwhelmed mental institutions spurred the quest for a solution to overcrowding. Enter James Watts and Walter Freeman, who popularized lobotomy in the United States after learning about the work of Dr. Moniz in Portugal. Moniz, a neurologist, was inspired by a presentation on removing frontal lobes from aggressive chimpanzees, which made them 'super Zen.' Despite minimal record-keeping, Moniz proclaimed his treatment a success in 1935. Walter Freeman, an ambitious doctor from a family of overachievers, saw an opportunity to make a name for himself by perfecting Moniz's technique. Not being a surgeon himself, he partnered with neurosurgeon James Watts. Together, they modified Moniz's technique, replacing the original method with a dull, flat knife inserted through the side of the skull, renaming it the 'lobotomy.' In September 1936, they performed their first lobotomy.
The first American lobotomy was performed on 63-year-old Alice Hammatt, who suffered from insomnia, anxiety, and severe depression. Diagnosed with agitated depression, her condition worsened with violent mood swings and sleeplessness. Faced with the choice between institutionalization and a lobotomy, Alice opted for the surgery, which Walter Freeman presented as a comprehensive solution. The procedure involved shaving her head, drilling two holes above her temples, and carefully severing nerve fibers connecting to her frontal lobe. Post-surgery, she was alert and able to communicate, correctly identifying her husband and objects. She reported feeling 'so much better' and 'so happy,' free from her old fears. While she experienced some slurred speech, Alice went on to live a 'somewhat normal, anxiety-free life.' This case became Walter and James's "poster child" for the effectiveness of lobotomy, described by the New York Times as "the surgery of the soul."
Alice Hammatt's positive outcome fueled Walter Freeman's ego, and he and James Watts aimed to perform 20 lobotomies by the end of the year to commercialize the procedure. Walter, embracing his grandfather's showmanship, toured the country, performing lobotomies in front of large audiences with a flamboyant style. He presented himself as 'the Willy Wonka of brain surgery,' contrasting with James Watts, who was more focused on medical implications. They strategically invited the press, leading to the New York Times' announcement of the lobotomy as "the surgery of the soul." The procedure was advertised as a cure for a wide range of issues, including depression, self-doubt, anxiety, schizophrenia, fear of aging, and 'unrest due to a loveless marriage,' primarily targeting women, who constituted the majority of their patients. They published their findings in a best-selling book, "Psychosurgery," reporting 63% improvement, 23% no change, and 14% worsening or death, with Walter focusing on the large percentage of improved patients.
Walter Freeman, not satisfied with his current reach, aimed to expand his patient base and simplify the lobotomy procedure. He proposed using it for headaches, a condition that was not actually treated by lobotomy. Inspired by an Italian colleague, Walter adopted a new approach that used an ice pick-like tool tapped through the eye socket, eliminating the need for drilling and making the surgery significantly faster. This 'ice pick' method allowed Walter, who was not a surgeon, to perform lobotomies himself, often without James and without strict sterilization, which he found 'annoying.' He performed nine surgeries without James's knowledge before revealing his 'improved' procedure. James Watts was infuriated, calling the new method 'gross' and a 'slap in the face to modern medicine,' leading to the end of their 13-year partnership. With James out of the picture, Walter continued his pursuit of 'lobotomies for everyone.'
In 1948, Moniz received the Nobel Prize in medicine for inventing the lobotomy, granting the procedure global credibility. This led to a surge in lobotomies worldwide, with Walter Freeman performing 228 transorbital lobotomies in just two weeks, charging an average of $200. Between the 1930s and 1970s, 40,000 to 50,000 lobotomies were performed in America, with Freeman responsible for roughly 10% of them. The majority of these procedures were performed on disenfranchised and powerless individuals, including older adults, the mentally ill, women, and even children. Howard Dully, a famous survivor, underwent a lobotomy at age 12, diagnosed with schizophrenia, and only learned about it as an adult. Homosexual tendencies were also considered a symptom of schizophrenia, leading to gay individuals potentially receiving lobotomies. The episode highlights that disproportionate numbers of Black people and women underwent lobotomies. The story of Gretchen, a woman whose husband pushed for her lobotomy due to her lack of sexual interest and 'graphic descriptions of her sexual fantasies with women,' illustrates how lobotomies were used to conform individuals to societal norms. Gretchen's procedure resulted in psychotic episodes, loss of artistic interest, and dependence on full-time care, becoming a more common and tragic outcome than the supposed successes.
By the late 1940s, public perception of lobotomies began to shift, with the American Medical Association criticizing the procedure for its destructive nature. Russia banned lobotomies in the 1950s, and rumors of its use for mind control on US soldiers further fueled public fear. The advent of psychotropic drugs in the 1950s offered an easier and less invasive solution for mental health treatment, causing a significant decline in lobotomy's popularity. Despite this, Walter Freeman remained in denial, continuing to tour and advocate for lobotomies, believing in its efficacy. His stubbornness was evident in 1961 when, heckled during a speech, he threw out 500 Christmas cards from former patients as proof of his success, revealing his deep need for validation. The final blow came in 1967 when Walter's last lobotomy patient died, forcing him to end his career. He had performed approximately 3,500 lobotomies. Later, dying of cancer, Walter embarked on a 'validation tour,' visiting former patients who found success to confirm his work wasn't in vain. His final report showed that 73% of schizophrenic patients were still hospitalized or dependent. Walter Freeman died in 1972, still refusing to admit that lobotomy wasn't a good thing. While variations of psychosurgery still exist, the lobotomy as practiced in Freeman's era is no longer used, thankfully replaced by pharmaceutical options.
The host reflects on the tragic history of lobotomy, emphasizing how easy it was to ruin lives, sometimes for a minimal cost. The story highlights the societal pressure to conform and 'be normal,' and how doctors like Walter Freeman, driven by ego and a desire for validation, performed procedures that caused immense P. The lack of oversight and basic medical ethics, such as sterilization, is also stressed. The podcast concludes by urging listeners to question medical practices and trust their instincts, using the analogy of not trusting a dentist with knee surgery. It encourages continued discussion on social media and promotes the host's other content.